Responding to Domestic Abuse and Violence with TeleMental Health Services

In the midst of the global pandemic caused by Covid-19, there has not been a greater moment in time for telehealth services to be utilized with a variety of individuals who are experiencing feelings of isolation, stressors from social and economic impact of the virus, restrictions with their day to day movements, and also the potential added level of control associated with domestic abuse and violence that has been brought to the forefront as result of the virus.

Join us in examining and discussing the impact that Covid-19 crisis has had on the state of mental health services and its subsequent impact on domestic abuse and violence withTherese Hugg, the Vice President of Therapy Services at Community Violence Intervention Center (CVIC) in Grand Forks, North Dakota. Ms. Hugg provides insight into how telehealth is being incorporated into the services that are being provided to clients of domestic abuse or violence. 

Ms. Hugg is a licensed professional counselor with 14 years of experience in the field of domestic and sexual abuse. At her current role she works to maintain the stability of crisis shelters and therapeutic services that are delivered to more than 1400 people on an annual basis. With about $3 million in grants Ms. Hugg seeks to provide safety and healing services in collaboration with a statewide treatment collaborative for individuals who have experienced trauma or are victims of trauma. At the heart of these services, CVIC serves as the catalyst for positive changes within the community by providing education, services, training, and actions that focus largely on addressing and ending domestic abuse and violence. The services are particularly unique in those direct services that are provided to both victims of domestic abuse and the abusers.

Ms. Hugg states that before the pandemic CVIC was working diligently to train staff and was able to quickly launch a telehealth service which was originally geared towards rural clients. With the onset of the COVID-19 the format quickly transitioned into one of only a few methods that CVIC could utilize to connect with its clients.In addition to the telehealth service, the crisis line and advocacy services were continuing to be offered by CVIC. According to Ms. Hugg, the advent of telehealth services allows for the provision of ongoing support, advocacy, and therapy services to victims of domestic violence. However, there have been some noteworthy considerations when it comes to the use of telehealth for domestic violence victims such as being aware of the potential of not being able to engage in therapy in the same space as the abuser due to the lack of a safe environment. The victim of domestic violence and the abuser may be residing more closely within the same space possibly due to stay at home orders and this may pose as a barrier to providing therapy services.  An example of a way that safety can be assessed in this situation would be to have the client use the camera to show their whole space. This can help to show that no one is there and deliver a sense of privacy within the given location. Ms. Hugg notes that there can be potential for the abuser to be monitoring the room through the use of various technologies so a recommendation is to assess the person being abused and the abuser to ensure that the person who is being abused is not using technology that the abuser may have access to. The ability to devise a safety plan and to formulate different scenarios in the event the abuser were to come home during the telehealth session is to be discussed prior to the established sessions. For instance, Ms. Hugg indicates that the use of coming up with passwords after specific phrases that one would have with the person who is being abused is one strategy or having a situational story in mind in the event someone were to come into the environment and talking was no longer an option. The ability to ensure the safety of the victim of domestic violence is key whether it through proper verification of identity for anyone who is calling for information or if the presenting issue is not abuse but the clinician suspects that it is present being able to talk about safety in general terms to the clients.

Ms. Hugg highlights that CVIC is also working to branch out with the use of telehealth with the launch of online support groups and also the potential for online chats on the road. As it currently stands, Ms. Hugg states that they are using Facebook and Instagram as a means for people to reach out for services. The abuse shelters still remain open as there is still a great need. While CVIC is based in North Dakota Ms. Hugg states that services are still able to be provided to those who call from out of state requesting services, but a significant amount of trainings and presentations are in North Dakota. For clinicians, it is important to be aware of mandated reporting requirements and recognizing when services may be needed and for clients is it also reporting if they have a suspicion of abuse or neglect in order to end violence within the community. 

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